大于胎龄儿胰岛素敏感性的临床研究  

Clinical study on insulin sensitivity in large-for-gestational-age infants

作　　者：邹宁 王金元 刘莹 李晓环[2] 

机构地区：[1]辽宁省大连市妇幼保健院新生儿科,116033 [2]大连医科大学护理学院

出　　处：《中国妇幼保健》2014年第19期3094-3096,共3页Maternal and Child Health Care of China

基　　金：大连市医学卫生科学研究计划项目〔2011-178-43〕;中华医学会医学教育分会;中国高等教育学会医学教育专业委员会2012年度医学教育立项课题〔2012-RW-31〕

摘　　要：目的：研究大于胎龄（LGA）儿是否存在胰岛素敏感性异常。方法：选取2011年5月～2012年1月在大连市妇幼保健院娩出的84例足月新生儿分为3组,母亲妊娠期糖尿病（GDM）LGA儿（LGA-GDM）32例,母亲非GDM LGA儿（LGA-non-GDM）27例,适于胎龄（AGA）儿25例。生后1 h内测量体重、身长,计算体重指数（BMI）。生后24～48 h空腹状态下采集股静脉血,电化学发光法测定胰岛素水平（FINS）,全自动生化分析仪测定甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）以及葡萄糖（FPG）。稳态模型评估（HOMA）胰岛素敏感性和胰岛分泌功能（HBCI）。结果：3组FPG、TG、TC、HDL-C和LDL-C水平差异无统计学意义（P〉0.05）。LGA-GDM组和LGA-non-GDM组的FINS水平差异无统计学意义（P〉0.05）,均高于AGA组（P〈0.05）。LGA-GDM组和LGA-nonGDM组的胰岛素抵抗指数（IRI）和胰岛素敏感指数（ISI）差异均无统计学意义（P〉0.05）,IRI均〉AGA组（P〈0.01）,ISI均0.05）。结论：LGA儿胰岛素敏感性降低。Objective： To research whether abnormal insulin sensitivity exists in large - for - gestational - age （LGA） infants. Methods： Eighty -four term neonates born in the hospital from May 2011 to January 2012 were enrolled and divided into three groups： 32 LGA infants of mothers with gestational diabetes mellitus （GDM） （ LGA - GDM）, 27 LGA infants of mothers without GDM （ LGA - non - GDM） and 25 appropriate - for - gestational - age （AGA） neonates. Body weight and body height were measured within one hour after birth, body mass index （BMI） was calculated. Thigh venous blood samples were obtained in the fasting state at 24 -48 hours after birth, in- sulin level was detected by electrochemiluminescence, automatic biochemical analyzer was used to detect the levels of TG, TC, HDL - C, LDL - C and FPG ; HOMA was used to evaluate insulin sensitivity and HBCI. Results ： There was no statistically significant difference in the levels of FPG, TG, TC, HDL - C and LDL - C among the three groups （P 〉 0. 05） ; there was no statistically significant difference in insu- lin level between LGA - GDM group and LGA - non - GDM group （ P 〉 0. 05 ）, which were statistically significantly higher than that in AGA group （P 〈 0. 05） . There was no statistically significant difference in insulin resistance index （IRI） and insulin sensitivity index （ISI） be- tween LGA - GDM group and LGA - non - GDM group （ P 〉 0. 05 ） , the levels of IRI in LGA - GDM group and LGA - non - GDM group were statistically significantly higher than that in AGA group （ P 〈 0. 01 ）, the levels of ISI in LGA - GDM group and LGA - non - GDM group were statistically significantly lower than that in AGA group （ P 〈 0. 05 ） ; there was no statistically significant difference in HBCI among the three groups （P 〉 0. 05 ） . Conclusion： Insulin sensitivity in in LGA infants decreases.

关 键 词：大于胎龄儿 妊娠期糖尿病 胰岛素敏感性 代谢综合征 

分 类 号：R714.5[医药卫生—妇产科学]